Potentially inappropriate prescription and polypharmacy are well-known risk factors for morbidity and mortality among older adults. However, recent systematic reviews have failed to demonstrate the overall survival benefits of deprescribing. Thus, it is necessary to synthesize the current evidence to provide a practical direction for future research and clinical practice. This review summarizes the existing body of evidence regarding deprescribing to identify useful intervention elements. There is evidence that even simple interventions, such as direct deprescribing targeted at risky medications and explicit criteria-based approaches, effectively reduce inappropriate prescribing. On the other hand, if the goal is to improve clinical outcomes such as hospitalization and emergency department visits, patient-centered multimodal interventions such as a combination of medication review, multidisciplinary collaboration, and patient education are likely to be more effective. We also consider the opportunities and challenges for deprescribing within the Japanese healthcare system.To break the chains of SARS-CoV-2 transmission and contain the coronavirus disease 2019 (COVID-19) pandemic, population-wide testing has been practiced in various countries. However, scant research has addressed this topic in Japan. In this modeling exercise, we extracted the number of daily reported cases of COVID-19 in Okinawa from October 1 to November 30, 2020, and explored possible scenarios for decreasing COVID-19 incidence by combining population-wide screening and/or social distancing policy. We reveal that permanent lockdown can be theoretically replaced by mass testing but sufficient target population at an adequate frequency must be mobilized. In addition, solely imposing a circuit breaker will not bring a favorable outcome in the long run, and mass testing presents implications for minimizing a period of lockdown. Our results highlight the importance of incentivizing citizens to join the frequent testing and ensure their appropriate isolation. This study also suggests that early containment of COVID-19 will be feasible in prefectures where the mobility is low and/or can be easily controlled for its geographic characteristics. https://www.selleckchem.com/products/sch-900776.html Rigorous investment in public health will be manifestly vital to contain COVID-19.Tokyo's Olympic and Paralympic Games set to begin in late July 2021 without spectators from abroad, but vaccine rollout has been slow in Japan compared with other developed countries. In this study, COVID-19 epidemic curve in Tokyo is developed based on weekly reported data from January 23, 2020, until April 16, 2021. The maximum daily number of infected cases in Tokyo in August 2021 would be 7,991 if the current pace of vaccinations would be used (1/1,000 per day). This daily number is greater than the highest daily cases (2,447) recorded on January 7, 2021. However, if the rollout pace could be doubled (1/500 per day), the peak daily new cases would be 4,470 in August. If it could be quadrupled (1/250 per day), the peak would be noted at 2,128 in July and the highest number in August would be 1,977. If vaccine rollout could not be enhanced, the cancellation might be an acceptable decision, since health is the most precious to local people and our Olympians.The cause for the damping of the Earth's free core nutation (FCN) and the free inner core nutation eigenmodes has been a matter of debate since the earliest reliable estimations from nutation observations were made available. Numerical studies are difficult given the extreme values of some of the parameters associated with the Earth's fluid outer core, where important energy dissipation mechanisms can take place. We present a fully 3D numerical model for the FCN capable of describing accurately viscous and Ohmic dissipation processes taking place in the bulk of the fluid core as well as in the boundary layers. We find an asymptotic regime, appropriate for Earth's parameters, where viscous and Ohmic processes contribute to the total damping, with the dissipation taking place almost exclusively in the boundary layers. By matching the observed nutational damping, we infer an enhanced effective viscosity matching and validating methods from previous studies. We suggest that turbulence caused by the Earth's precession can be a source for the enhanced viscosity.We explored how algorithm (model) and in situ measurement (observation) uncertainties can effectively be incorporated into empirical ocean color model development and assessment. In this study we focused on methods for deriving the particulate backscattering coefficient at 555 nm, b bp (555) (m-1). We developed a simple empirical algorithm for deriving b bp (555) as a function of a remote sensing reflectance line height (LH) metric. Model training was performed using a high-quality bio-optical dataset that contains coincident in situ measurements of the spectral remote sensing reflectances, R rs (λ) (sr-1), and the spectral particulate backscattering coefficients, b bp (λ). The LH metric used is defined as the magnitude of R rs (555) relative to a linear baseline drawn between R rs (490) and R rs (670). Using an independent validation dataset, we compared the skill of the LH-based model with two other models. We used contemporary validation metrics, including bias and mean absolute error (MAE), that were corrected for model and observation uncertainties. The results demonstrated that measurement uncertainties do indeed impact contemporary validation metrics such as mean bias and MAE. Zeta-scores and z-tests for overlapping confidence intervals were also explored as potential methods for assessing model skill.Microplastic debris ending up at the sea surface has become a known major environmental issue. However, how microplastic particles move and when they sink in the ocean remains largely unknown. Here, we model microplastic subject to biofouling (algal growth on a substrate) to estimate sinking timescales and the time to reach the depth where particles stop sinking. We combine NEMO-MEDUSA 2.0 output, that represents hydrodynamic and biological properties of seawater, with a particle-tracking framework. Different sizes and densities of particles (for different types of plastic) are simulated, showing that the global distribution of sinking timescales is largely size-dependent as opposed to density-dependent. The smallest particles we simulate (0.1 μm) start sinking almost immediately around the globe and their trajectories take the longest time to reach their first sinking depth (relative to larger particles). In oligotrophic subtropical gyres with low algal concentrations, particles between 1 and 0.01 mm do not sink within the simulation time of 90 days.